Debate: How can tech pave the way to stronger health systems?

Health debate
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Health debate


Universal healthcare remains elusive for many countries in the global South. Less than half the world’s population gets the healthcare they need, according to the WHO. In many countries, government clinics are scarce and deprived of supplies and funds. Decades of under-funding have eroded trust in public health systems, while in rural areas, the long distances to reach clinics mean that face-to-face contact with doctors is rare.
Poor public health systems force millions of people to fork out for private medical care, further pushing them into poverty. For millions more, private services are unaffordable, meaning ill health and disease go untreated, with devastating results. Often, it is women and children who suffer most. In 2016, 15,000 under-fives died every day. In 2015, over 300,000 women died due to pregnancy or childbirth complications – 99 per cent of them in low- and middle-income countries.
The fragility and chronic underfunding of health systems also means that during health emergencies – such as the Ebola crisis of 2014-2016 – health systems can simply collapse.  
On Tuesday 27 November at 14:00-16:00 GMT, SciDev.Net, supported by the Rockefeller Foundation, brought together a global panel of experts to explore the role of community health workers – the front line workers underpinning health systems in poor countries. Appointed by their community and uniquely placed to understand local contexts and culture, these health workers often plug the gap left by mainstream services, stepping in to provide primary healthcare, pre-natal services, support for chronic diseases or emergency care.
This debate focused on ways that tech and training can help improve the services provided by community health workers. Our panel explored how mobile-based healthcare (mhealth) and ICT-based healthcare (eHealth) can help transform health systems in poor countries, particularly in rural areas where doctors and clinics are few and far between. It will also examine how locally designed innovations can shore up healthcare for millions of people.
Experts – including front-line health workers and the public – debated what works, what has failed and why, and what countries need to do to support innovative solutions to longstanding problems.

The panellists

Elaine Baker, digital health specialist, PATH, Tanzania
Cosmas Bunywera, Peek Vision coordinator, Kitale County and Referral Hospital, Kenya @peekteam @genious_cos 
Dr Mosoka Fallah, deputy director general for technical services, National Public Health Institute of Liberia (NPHIL). Visiting scientist, Harvard School of Public Health. Liberia/US. @mfallah1969  
Dr Arun Gadre, gynaecologist and coordinator, SATHI-CEHAT, India  
Dr Hana Rohan, assistant professor in social science, London School of Hygiene & Tropical Medicine, UK
Dr Zaher Sahloul, president, MedGlobal, US/global @sahloul


Imogen Mathers, producer at SciDev.Net

Debate questions

1. What do you consider to be the most serious problems facing health systems in the countries where you’ve worked?
2. What role do community health workers play in these healthcare systems and how can the services they provide be improved?
3. Where have you seen low-cost tech like mhealth services function well and less well in health systems, and what are the reasons for this?
4. Where have you seen locally designed innovation prove effective in strengthening health systems?
5. What is holding back the use of tech and local innovation, and what changes need to happen to nurture it and scale up its use?
6. What do you see as the most potentially transformative tech opportunities over the next few years, and how can governments and international organisations ensure tech is accessible and sustainable?

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